Official Publication of the NATIONAL ASSOCIATION OF VA PHYSICIANS & DENTISTS Visit the NAVAPD Website at www.NAVAPD.ORG For Information on NAVAPD email us at [email protected] Volume 37, Number 2 The Voice of VA Physicians and Dentists Since 1975 July 2015 NAVAPD Staff NAVAPD President Testifies to House VA Subcommittee Editorial Editor-in-Chief: n May 15, 2015, NAVAPD President Samu- cians in the VA feel their suggestions are unhelpful Samuel V. Spagnolo, MD Managing Editor: el V. Spagnolo testified before the United and unwanted,” he said. Larry H. Conway, RRT O States House of Representatives Veterans Affairs Subcommittee on Health at the Cannon “In many VAs, physicians and dentists are no long- Publishing Communications Director: House Office Building. The hearing, Overcoming er considered professionals and are simply called Larry H. Conway, RRT Barriers to ‘workers,’” he Consultant: More Efficient explained. Carol Blymire and Effective Operations VA Staffing, To see Dr. Website Administrator: focused on Spagnolo’s full Andrew Vines what progress testimony as Legal Counsel the VA has well as the full Robert Kirshner made in hiring hearing, go additional online to medical pro- c-span.org and Inside this issue: fessionals type “veterans since Con- affairs health President’s Corner 2 gress allocat- care staffing” VA Whislteblower ed $16 million into the search Cases Remain 2 to assist with field. Overwhelming this effort. As VA Planning to part of this NAVAPD and all Outsource Hepatitis C 3 discussion, the subcommittee members and wit- other witnesses submitted written testimony to Treatment nesses focused on issues that impede or slow hir- expand and support their verbal testimony. You VA Seeks Budget ing efforts, issues can read NAVAPD’s Flexibility from 4 that make retention written testimony Congress of these caregivers online at http:// New VA Under difficult, how the VA veterans.house.gov/ Secretary Sworn In 5 assesses how many witness-testimony/ physicians and other samuel-v-spagnolo. Studies Using MVP 5 medical professionals Data Announced are needed, and how One issue that got lots NAVAPD President 6 the productivity of of attention in discus- Addresses ASA these caregivers is sion and questions by Federal Funding assessed. both witnesses and Critical for Hepatitis 6 committee members C Treatment Dr. Spagnolo’s com- was the dysfunctional ments were largely state of the Human Legislative Update 7 about the ongoing Resources process in diminution and disen- the VA. It was revealed NAVAPD Mission and Principles/ 7 franchisement of phy- that hiring an individu- Officers and Board sicians in the VA, as Dr. Spagnolo (2nd from left) testifies al can take 6 to 12 well as the lack of months. ¤ Publication Policy 8 support staff who would allow physicians to be more efficient in seeing Veterans. “Most physi- Short Application Form 8 Page 2 NAVAPD News The President’s Corner Samuel V. Spagnolo, MD ate hash out budget issues around the work. I know many of you are frustrat- Department of Veterans Affairs. ed. I know some of you are ready to leave your service and go to the private Regardless of what Congress does — sector. We hear you, and we will con- and we’re in regular communication tinue to work for you here in Washing- with Veterans Affairs Committee and ton to make sure your voices are heard. Health Subcommittee leadership in the House and Senate — what matters to We appreciate that you have renewed us is how that money is allocated by your membership and that you contin- the VA. I am sure you are as frustrated ue to recruit new members to as I am by the continued bad headlines NAVAPD. We are lean in staff and ex- in the news all across the country about penses, and all the dues you pay go to over-budget construction, misuse of supporting our time on Capitol Hill and ill Congress be able to pass funds, poor care, and still-long wait VA Central Office advocating for your a budget deal before the times. We hear from many of you, and needs and the needs of our veter- W fiscal year ends on Septem- pass along your concerns to the powers ans. Please keep reaching out to ber 30, or will we subsist on a series of that be. With the recent resignation of us. Please keep having conversations ongoing Continuing Resolutions as we the VA’s Inspector General, we can only in your facilities about what’s working have in the past? No one can be sure, hope things will improve. It will take and what’s not. but for the first time in a long time years to reverse the decades of spend- we’re seeing bipartisan collaboration ing abuse and overall mismanagement We are here for you, and we want to around biomedical research when it in many of the VA Medical Centers … hear your stories. It’s the only way we comes to NIH funding, and we can only but I am proud of all the NAVAPD mem- can work smarter and harder for you. I hope that kind of cooperation will ex- bers who continue to push through the hope you are taking a little time to en- tend to veterans’ issues when commit- bureaucracy every day to care for our joy the summer, and I thank you for tees and leaders in the House and Sen- nation’s veterans. I know it’s hard serving our nation’s veterans. ¤ VA Whistleblower Cases Remain “Overwhelming” Says OSC arolyn Lerner, head of the inde- filed whistleblower retaliation com- created Office of Accountability Review, pendent Office of Special Coun- plaints, Lerner said, including a land- said the agency's responsibility to pro- C sel, says the number of whistle- mark settlement for three employees tect whistleblowers is an integral part of blower cases at the VA remains who suffered retaliation after filing its mission. "VA is fully committee to "overwhelming," a year after the care whistleblower complaints at the trou- correcting deficiencies in its processes delay scandal broke. Complaints of bled Phoenix VA hospital, the epicenter and programs, and to ensuring fair waste, fraud, abuse, and threats to the of the wait time scandal. treatment for whistleblowers who bring health and safety of veterans continue those deficiencies to light," Flanz said. to pour in. So many complaints have The numbers may point to an ongoing been filed that VA cases represent 40% problem, but could be viewed as part of An investigation by The Associated of all incoming cases investigated by a larger effort to restore accountability Press revealed the number of patients her agency, which has jurisdiction over at the VA, Lerner told the House VA sub- facing long waits has not declined. the entire federal government. committee. "The current, elevated Nearly 894,000 medical appointments numbers of VA whistleblower cases do at VA medical facilities from Aug. 1 to The counsel's office is examining about not necessarily mean there is more Feb. 28 failed to meet the VA's timeli- 110 pending claims of retaliation retaliation than before the scheduling ness goal of 30 days; nearly 232,000 against whistleblowers who filed com- and wait list problems came to light, or of those appointments involved a delay plaints involving patient health and that there are more threats to patient of longer than 60 days. safety, scheduling and understaffing, health and safety," Lerner said. Lerner said. The pending claims involve "Instead, these numbers may indicate Delays were not spread evenly through- VA facilities in 38 states and the Dis- greater awareness of whistleblower out the VA. Many were clustered at VA trict of Columbia. rights and greater employee confidence facilities in a handful of Southern in the systems designed to protect states, often in areas with a strong mili- Since last year, the special counsel's them." tary presence, a partly rural population office has secured either full or partial and patient growth that has easily out- relief for 45 VA employees who have Meghan Flanz, director of VA's newly paced the VA's sluggish planning pro- Volume 37, Number 2 Page 3 VA Planning to Outsource Hepatitis C Treatment n another article in this issue, we letter to VA Secretary Robert McDonald a disaster for patients, providers and discuss how critical funding is to dismay at this unacceptable develop- VA." I the use of new therapy for Hepati- ment. tis C that appears to cure more than The VA had set aside nearly $700 mil- 90% of treated patient. Now it appears "... To halt hepatitis C treatment at VHA lion this year for HCV antiviral drugs. the VA is moving to outsource Hepatitis facilities now would be unconsciona- Department officials confirmed soaring C care for up to 180,000 veterans with ble," they wrote. "We can and must end patient loads and medication expenses this condition through the VA Choice the epidemic. Once we have treated have nearly wiped out that budget with Plan. The VA is taking these steps be- every veteran with hepatitis C, the several months to go in the federal cause the expense of the Hepatitis C costs will go away. ... Give us the am- fiscal year that ends Sept. 30. That's drugs has exhausted the funding set munition, and we will win this war." an estimated $400 million shortfall aside for drug therapies. In the end, with more dramatic costs expected, the total cost for all infected veterans The transition plan for so-called Hepati- beginning in October. could amount to billions of dollars. tis C Virus (HCV) patients was devel- oped by a working group chaired by A VA clinician who asked not to be The VA has spent weeks developing a Kenneth Berkowitz, acting executive named for fear of retaliation stressed dramatic and controversial transition director of VHA's National Center for that department leaders "haven't told as patient loads have surged and fund- Ethics in Health Care.